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진행성 간세포암에서의 경피적 간동맥포트설치술을 이용한 화학요법과 체외 방사선 조사의 병용요법

Other Titles
 Combined Therapy involving Hepatic Arterial Chemoinfusion through a Percutaneously Implanted Port, and External Irradiation for Advanced Hepatocellular Carcinoma 
Authors
 원종윤  ;  이도연  ;  박성일  ;  이종태  ;  문영명  ;  전재윤  ;  한광협  ;  성진실  ;  김종원  ;  서상현 
Citation
 Journal of the Korean Radiologist Society (대한방사선의학회지), Vol.47(6) : 583-590, 2002 
Journal Title
Journal of the Korean Radiologist Society(대한방사선의학회지)
ISSN
 1738-2637 
Issue Date
2002
Keywords
Liver neoplasms ; therapyCatheters and catheterizationChemotherapy ; regionalLiver ; effects of irradiation on
Abstract
Purpose: To evaluate the efficacy of combined therapy involving intra-arterial hepatic chemoinfusion through a percutaneously implanted port and external irradiation for the treatment of advanced hepatocellular carcinoma. Materials and Methods: Fifteen patients (12 males and 3 females; mean age=47.5 years) with advanced hepatocellular carcinoma localized in one lobe and with portal vein thrombosis (stage IVa) were included in this study. To permit chemoinfusion through the hepatic artery, a Chemoport? was implanted percutaneously in the right inguinal area via the femoral artery. Initial external radiation therapy lasted five weeks (44 Gy in a daily fraction of 1.8 Gy), with concurrent intra-arterial hepatic infusion of 5-fluorouracil. This initial treatment was followed by five cycles of intra-arterial hepatic infusion of cisplatin and 5-fluorouracil for three consecutive days every month. Two and six months after treatment was begun, the patients underwent CT scanning and angiography, and their response was assessed in terms of change in tumor size and vascularity, the degree of portal vein thrombosis and arterio-portal shunt, and alpha-fetoprotein levels. Any complications arising from this combined therapy and the clinical status of each patient were also followed up during the treatment period. Results: The response rates at months 2 and 6 were 60% and 33.3%, respectively. One patient (6.7%) showed complete remission, and serum alpha-fetoprotein levels decreased significantly in all patients who responded. In five of the twelve patients, the thrombi in the main portal vein showed marked regression. The one-year survival rate was 30% and the median survival period was 10.6 (range, 3.7 to 28) months. The complications arising after treatment involved the catheter-port system (n=2) or were due to gastroduodenitis (n=9). Conclusion: In these patients with advanced hepatocellular carcinoma and portal vein thronbosis, combined therapy involving hepatic arterial chemoinfusion through a Chemoport? and external irradiation achieved favorable results. Further controlled studies aimed at evaluating the prognostic factors involved are, however, required.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
Lee, Do Yun(이도연)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/143587
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